Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.
Musculoskeletal Radiology Unit, Varelli Institute, Naples, Italy.
Skeletal Radiol. 2021 Sep;50(9):1863-1871. doi: 10.1007/s00256-021-03710-1. Epub 2021 Mar 17.
The aim of this work was to evaluate the inter-observer agreement and diagnostic performance values of 7 MRI signs (3 known and 4 new) of long head biceps tendon instability.
MRI of 86 patients were retrospectively evaluated. Inter-observer agreement and diagnostic performance of each diagnostic sign and of all combined signs (with the exception of detour sign) were tested for identification of biceps tendon instability, with arthroscopy as the reference standard.
Agreement between expert operators was moderate to good. Sensitivity, specificity, and sign accuracy showed a variation respectively of the following: humeral chondral print 72-80%, 62-68%, and 70-76%; subchondral bone edema 24-31%, 84-97%, and 50%; biceps tendon angle 60-71%, 97-100%, and 74-81%, biceps tendon-groove distance 31-47%, 90-100%, and 56-64%; long head biceps subluxation/dislocation on axial plane 49-53%, 97-100%, and 66-70%; displacement sign 74-80%, 74-100%, and 74-87%; detour sign 51-64%, 58-81%, and 62-64%; and all signs 98-100%, 32-61%, and 75-86%.
These diagnostic signs, both known and new, individually and/or in combination, provide a valid tool in the MRI diagnosis of long head biceps tendon instability.
本研究旨在评估 7 种 MRI 征象（3 种已知征象和 4 种新征象）在诊断长头肌腱不稳定中的观察者间一致性和诊断性能值。
回顾性分析了 86 例患者的 MRI 资料。以关节镜检查为参考标准，测试每种诊断征象以及所有组合征象（除绕行征外）对识别肱二头肌肌腱不稳定的观察者间一致性和诊断性能。
专家操作者之间的一致性为中度至高度。敏感性、特异性和征象准确性的变化分别为：肱骨软骨压迹 72%-80%、62%-68%和 70%-76%；软骨下骨水肿 24%-31%、84%-97%和 50%；二头肌肌腱角 60%-71%、97%-100%和 74%-81%，二头肌肌腱-沟距离 31%-47%、90%-100%和 56%-64%；轴向平面上长头肌腱半脱位/脱位 49%-53%、97%-100%和 66%-70%；移位征象 74%-80%、74%-100%和 74%-87%；绕行征 51%-64%、58%-81%和 62%-64%；所有征象 98%-100%、32%-61%和 75%-86%。
这些诊断征象，无论是已知的还是新的，单独或联合使用，都为长头肌腱不稳定的 MRI 诊断提供了有效的工具。
